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Another study links PPIs and dementia: AGA expert weighs in

Dr. Fouad J. Moawad comments on a new observational study published in Neurology; plus three talking points for your patients.
Graphic with Fouad J. Moawad, MD, headshot and quote on PPIs and dementia
Graphic with Fouad J. Moawad, MD, headshot and quote on PPIs and dementia

A new study published Aug. 9 in Neurology found an association between longterm proton-pump inhibitors (PPI) use and dementia. This was an observational study and does not prove that acid reflux drugs cause dementia. 

In this study, the authors note that long term PPI use, defined as more than 4.5 years of use, was associated with dementia. It is important to note, however, that this does not necessarily mean that PPIs cause dementia. With observational studies, there is an inherent risk of bias and confounding, as the authors’ report. Some of these confounders include H. pylori status, vitamin B12 deficiency, depression and socioeconomic status. says Fouad J. Moawad, MD, graduate of the AGA Future Leaders Program and gastroenterologist at Scripps Health in San Diego, California. 

A 2017 study led by Andrew T. Chan, MD, MPH, of Mass General Brigham, Boston, examined the association between proton pump inhibitor use and cognitive function in women. The investigators found no “convincing association between PPI use and cognitive function. Our data do not support the suggestion that PPI use increases dementia risk.”

A new article in press in Gastroenterology by Raaj S. Mehta and colleagues also studied this issue and concluded that in adults 65 years of age or older, PPIs were not associated with dementia or decline in cognition over time. These data provide reassurance about the safety of long-term use of PPIs among older adults.

The headlines may be confusing for your patients. Here are AGA’s three talking points for your patients taking PPIs:

  • Talk to me, your doctor, before making any changes to your medication.

    You have been prescribed PPIs for a reason, to treat a diagnosed medical condition. We can discuss the reason for your prescription, the dose and the timeframe for treatment.

  • Consider lifestyle modifications. 

    These may reduce or eliminate the need for PPIs for long-term use. These may include weight loss, avoiding tobacco or a change in your eating patterns. We can work together to determine the changes that are right for you.

  • Keep in touch.

    Research continues to be done on PPI use. While the latest research and headlines on PPIs may seem scary, current research still recommends that patients who have a diagnosed condition that is helped by PPIs should stay on them, as benefits can outweigh risks.

AGA clinical guidance

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